摘要
目的设计和制造锁骨交锁髓内钉，探讨其固定锁骨中段骨折的生物力学性能，并与传统的钢板螺钉和单枚克氏针内固定方法进行比较，为临床应用提供科学依据。方法采集15例成年人新鲜锁骨标本。制作锁骨中段骨折模型，按临床手术方法予以固定并分为三组：锁骨交锁髓内钉组、钢板螺钉固定组、克氏针内固定组，每组5例标本。运用试验应力分析手段测试三组的生物力学性能并进行比较。结果在载荷1000N时，锁骨交锁髓内钉组锁骨弯曲强度和锁骨弯曲刚度分别为（57．41±4．72）、（2．28±0．17）N，与钢板螺钉固定组[（58．50±4．14）、（2．26±0．20）N]比较差异无统计学意义（P〉O．05），而与克氏针内固定组[（51．14±4．32）、（1．54±0．16）N]比较差异有统计学意义（P〈0．05），而且钢板螺钉固定组与克氏针内固定组锁骨弯曲强度和锁骨弯曲刚度比较差异也有统计学意义（P〈0．05）。扭转力学试验：锁骨交锁髓内钉组的扭矩与钢板螺钉固定组的扭矩比较差异无统计学意义（P〉o．05），与克氏针内固定组比较差异有统计学意义（F=14．88，P〈0．05）。压缩试验：锁骨交锁髓内钉组极限载荷为（1246±87）N，与钢板螺钉固定组的（1348±121）N比较差异无统计学意义（P〉0．05），而与克氏针内固定组的（870±72）N比较差异有统计学意义（F=14．74，P〈0．05）。结论采用锁骨交锁髓内钉固定锁骨中段骨折，其锁骨弯曲强度、刚度和稳定性等生物力学性能优越，微创手术内固定操作方便，比其他方式内固定有一定的优势。
Objective To discuss the biomechanical properties of clavicle intramedullary nail in fixing middle fracture of clavicle and compare with the traditional plate and screw and single Kirschner wire, in order to provide scientific evidence for clinical application. Methods Fifteen adult cadaver were collected to make middle fracture of clavicle models. According to the clinical operation methods, the fracture models were divided into three groups with 5 specimens each： clavicle intramedullary nail group, plate and screw fixation group, and Kirschner wire internal fixation group. Biomechanical properties of three groups were tested and compared by experimental stress analysis method. Results In the load 1000 N, the bending strength and bending stiffness of clavicle intramedullary nail group [ （57.41 ± 4.72 ）, （2.28 ± 0.17 ） N ] had no significant difference compared with those of plate and screw fixation group [ （58.50 ± 4.14）, （2.26 ± 0.20） N ] （P 〉 0.05 ）, while had statistical significance compared with Kirschner wire internal Lxation group [（51.14 ±4.32）, （1.54 ± 0.16） N] （P 〈 0.05）. The bending strength and bending stiffness had statistical significance between plate and screw fixation group and Kirschner wire internal fixation group （P 〈 0.05 ）. In the torsional mechanical test, torque of clavicle intramedullary nail group had no significant difference compared with plate and screw fixation group （P 〉 0.05）, but had statistical significance compared with Kirschner wire internal fixation group （F = 14.88,P 〈 0.05）. In compression test of the clavicle, the compression limit load of clavicle intramedullary nail group [ （ 1246 ± 87） N ] had no statistical significance compared with plate and screw fixation group [ （1348 ± 121 ） N ] （P 〉 0.05）, and had significant difference compared with Kirschner wire internal fixation group [ （870 ± 72） N ] （F = 14.74, P 〈 0.05 ）. Conclusions Clavicle intramedullary nailing for treating middle fracture of clavicle can provide better biomechanical strength, stiffness and stability. Meanwhile as a minimally invasive operation,this operation method is feasible. Compared to other internal fixation methods, it has certain advantages.
出处
《中国医师进修杂志》
2012年第14期1-4,共4页
Chinese Journal of Postgraduates of Medicine
基金
上海市卫生局科研项目（2006-118）
关键词
锁骨
骨折
生物力学
外科手术
髓内钉
Clavicle
Fractures, bone
Biomechanics
Surgical procedures, operative
Intramedullary nail
